HomeMy WebLinkAboutAgenda - 01-26-2004-9d1ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: January 26, 2004
Action Agenda.
Item No. 9 - d -
SUBJECT: Adult Care Home Community Advisory Committee
DEPARTMENT: Board of Commissioners PUBLIC HEARING: (Y/N) No
ATTACHMENT(S): Under Separate Cover
Membership Roster
Letter of Recommendation
Interest List
Applications(s)/Resume(s) of Person(s) on
the Interest List
INFORMATION CONTACT:
Clerk's Office, ext. 2130, 2125, 2126, 2129
TELEPHONE NUMBERS:
Hillsborough 245-2130
Chapel Hill 968-4501
Durham 688-7331
Mebane 336-227-2031
PURPOSE: To consider an appointment to the Adult Care Home Community Advisory,
Committee (A.C.H.C.A.C.).
BACKGROUND: In its business meeting on Wednesday, January, 7, 2004, the Orange
County Adult Care Home Community Advisory Committee voted unanimously to nominate
Frances Kovens, of 1010 Pinehurst Drive, Chapel Hill, N.C. 27517, to the Orange County
Commissioners for one of the committee's open member slots. This recommendation is based
on Ms: Kovens' experience, education, interest and passion for effecting change with residents
of long term care facilities.
If appointed, her term would be an initial one-year training term, after which she may become
eligible to be reappointed to a regular two-year term.
FINANCIAL IMPACT: A stipend of $13.00 is paid to each member of this Committee per each
meeting attended. This would be $156.00 per fiscal year if the member participates in all of the
meetings that year.
RECOMMENDATION(S): Consider appointing Ms. Frances Kovens to the Adult Care Home
Community Advisory Committee for a one-year training term to expire March 31, 2005.
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Triangle J Council of Governments
Triangle 1 Area Agency on Aging--Ombudsman Program
Jill V. Passmore, Region J Lead Ombudsman
5
P O Box 12276
Research Triangle Park, N.C. 27709
Phone(919)558-9401
Fax(919)549-9390
To: Nancy Glover
From: Jill V. Passmore
Date: January 12, 2004
Re: Official nomination for the Orange Adult Care Home Community Advisory Committee
Cc: Laura Deloye and Carol Gunther-Mohr, OACCAC
Nancy,
I am contacting you on behalf of the Orange County Adult Care Home Community Advisory
Committee
In their business meeting on Wednesday, January 7, 2004, the Orange County Adult Care Home
Community Advisory Committee voted unanimously to nominate Frances Kovens to the
Orange County Commissioners for one of the committee's open member slots. This
recommendation is based on Ms. Kovens' experience, education, interest and passion for effecting
change with residents of long tern care facilities.
Please let me know:
that you have received this official nomination,
when the nomination might be shared with the County Commissioners and
in what time frame the appointment might occur.
Than]( you, Nancy, and do not hesitate to let me Icnow if you need further information. You are
welcome to email me at this address: impassmore(@,,aol.com or to call my cellphone at 423-1444.
Jill
Jill V. Passmore
Region J Lead LTC Ombudsman
Triangle J Council of Governments
Triangle J Area Agency on Aging
6
Page 1 of 1
Frances Kovens
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background
Date of Birth:
Ms. Frances Kovens
1010 Pinehurst Drive
Chapel Hill NC 27517
919-602-1301
919-929-7434
919-929-7589
fkovens@nc.rr.com
Duke Medical Center
RN - Pt. Resource Mgr.
Female
Caucasian
6/17/1957
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Advisory Board on Aging
Work Experience:
RN 6 yrs. @ DUMC ; prior to that short term construction, UNC Hospitals
Volunteer Experience:
Hadassah, various school activities in Chapel Hill School System
Education:
BSN
Other Comments:
Due to the nature of my position @ Duke - largely discharge planning - co-ordination and
care - I feel I have knowledge of the aging population health care needs and social
network supports. Would very much want to interface with the Chapel Hill Community
efforts to provide support and resources to this group of citizens. Originally applied
11/5/03 for ACHCAC and ADV. Board on Aging. Address Verification:
This application was current on: 11/5/2003 Date Printed: 1/14/2004
7
Applicant Interest Listing by Board Name and by Applicant Name
Contact Person:
Adult Care Horne Community Advisory Committee Contact Phone: Pam Tillet
919-968-2084
MS. Arm ChamUedin Day Phone: 919-383-8105 Sex: Female
2329 Palls Dr Evening Phone: 919-383-8105 Race: Undesignated
Chapel Hill NC 27514 FAX: Township:
E-mail: acandcmnearthlink net Date Applied: 12/19/2003
Skills: a A Psychology Also Scrves On:
Skills: Elementary School Reader Volunteer Also Serves On:
Skills: M P T UNC School of Medicine Also Serves On:
Skills: Physical Therapist Also Serves On:
Skills: Program Coordinator Also Serves On:
Ms. Laurin Easthom
305 Rowe Road
Chapel Flill NC 27516
Skills: Dentist
Day Phone: 919-942-0001
Evening Phone: 919-773-3002
FAX: 919-773-8824
E-mail:
Also Serves On:
Sex: Female
Race:
Township: Chapel Mill
Date Applied: 10/29/2003
Mfs,Jerry Ann Gregor-y Day Phone: 919-933-8481 Sex: Female
917 Crestwood Lane Evening Phone: 919-933-8481 Race: Caucasian
Chapel Hill NC 27517 FAX: Township: Chapel Bill
E-mail: jkgregoryn.mindspring com Date Applied: 11/02/2003
Skills: Also Serves On:
Skills: Public health Also Scrves On:
Skills: Registered Nurse Also Serves On:
Ms Johanna Jensen Day Phone: 225-1925 Sex: Female
2201 6aycourt Trail Evening Phone: 245-1637 Race: Caucasian
Flillsborough NC 27278 FAX: Township: Hillsborough
E-mail: jjensenj n mindspring. com Date Applied: 11/09/2003
Skills: Medical Technologist Also Serves On: Commission for Women
Ms. Frances KOVens Day Phone: 919-602-1301 Sex: female
1010 Pinchurst Drive Evening Phone: 919-929-7434 Race: Caucasian
Chapel Hill NC 27517 FAX: 919-929-7589 Township:
E-mail: lkovens r@nc a com Date Applied: 11/05/2003
Skills: Registered Nurse Also Serves On:
Thursday, January 15, 2004 Page I of 2
9
Applicant Interest Listing
Adult Care Honte Community Advisory Committee
by Board Name and by Applicant Name
Contact Person: Pam Tillet
Contact Phone: 919-968-2084
Ms. Judith Mitchell Day Phone: (919)933-8381 Sex: Female
3620 Dairyland Road Evening Phone: 919-933-1851 Race: Caucasian
Hillsborough NC 27278 FAX: 919-933-6623 Township: Bingha
mm
E-mail: jmitchcll58ncmddink net Date Applied: ?
,9J-4Mr'00l
Skills: Community Service Volunteer Also Serves On: 11"15'0,3
Shills: EMT Also Servcs On:
Skills: Receptionist Also Serves Ow
MS. Shanon Pounds Day Phone: 919-732-2133 Sex: Female
200 South Bellvue Street Evening Phone: 919-732-2133 Race: Caucasian
Hillsborough NC 27278 FAX: Township: Hillsborough
E-mail: MrsPounds n,aol com Date Applied: 12/03/2003
Skills: Animal Welfare Advocate Also Serves On:
Skills: Community Service Volunteer Also Serves On:
Skills: Hillsborough City Limits Also Serves On:
Thursday, January 15, 2004 Page 2 of 2
9
Page 1 of 1
Ann Chamberlin
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence
Zone of Residence:
Sex:
Ethnic Background
Date of Birth:
Ms, Ann Chamberlin
2329 Falls Dr,
Chapel Hill NC 27514
919-383-8105
919-383-8105
acandcm@earthlink.net
La Salle Health Care
Physical Therapist
Chapel Hill
Chapel Hill Twnsp
Female
Undesiqnated
11/6/1957
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
La Salle Healthcare Durham, 10/03-present; Durham Reg. Hasp, 10/03 - 12/02; UNC
School of Medicine, Project Mgr, Research; 10/96 - 8/00; School of Nursing, UNC 8/95 -
9/96 , Project Mgr,; UNC Sch. Of Medicine, 4/92- 4/95; 12/86 - 12/91 Program
Coordinator, Western Man Hospital, Westfield, MT,
Volunteer Experience:
New Hope Elem. Sch. Reader, 1995-1997, 2002-2003. IFC Community Shelter, 8/96 -
5/97,
Education:
2002 MPT UNC Sch. Of Medicine, Div. Of Physical Therapy; 1984 UNC Sch. Of Public
Health, Dept. of Health, Behavior and Health Education, 1979, B.A. Psychology, SUNY
@Binghamton,
Other Comments:
STAFF NOTES: Origninally applied 12/19/03 for Adult Care Home Community Advisory
Committee. ADDRESS VERIFICATION: 2329 Falls Drive, Chapel Hill, 27514 is in
Chapel Hill Township, Outside City Limits, Not in ETJ. MOAD,ncg.
This application was current on: 12/19/2003 Date Printed: 1/15/2004
/O
Page 1 of 1
Laurin Easthom
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms. Laurin Easthom
305 Rowe Road
Chapel Hill NC 27516
919-942-0001
919-773-3002
919-773-8824
Medicaid Dental Center
Dentist
Chapel Hill
Female
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Currently I am a dentist (part-time) treating underprivileged children (medicaid) in
Raleigh. I have also been a general dentist treating adults/elderly. I also (before a
dentist) was a case manager in rehabilitation aiding injured workers find adequate
employment.
Volunteer Experience:
In college, I volunteered at nursing homes assisting /entertaining residents. I was a
hospital volunteer in physical therapy for a year in my master's program at USC.
Education:
B.A. History (1986), Davidson College; M.Ed. (1988) (Master of Education) Counseling at
Univ. So. Carolina, D.D.S. & NC Chapel Hill in 1998.
Other Comments:
Original Application submitted on 10/29/03 for Adult Care Home Community Advisory
Committee. I have had friends/family in nursing homes (still do). I deeply care about this
population - they have given their long lives to society and have weathered many a storm
and have so much to tell - we owe them our greatest respect in the world. They deserve
the best and demand our greatest respect and empathy. I want to help them. Address
Verification: 305 Rowe Road is in CH ETJ current 10/30/03.
This application was current on: 10/29/2003 9:49:44 PM Date Printed: 1/15/2004
Page 1 of 1
Jerry Ann Gregory
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms. Jerry Ann Gregory
917 Crestwood Lane
Chapel Hill NC 27514
919-933-8481
919-933-8481
919-968-2013
Jkgregory@mindspring.com
O.C. Health Dept; Maxim Health Service
Flu Immunization Nurse
Township of Residence: Chapel Hill
Zone of Residence: ETJ
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 1/12/1945
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Advisory Board on Aging
Work Experience:
32 Years at Orange County Health Dept, as nurse - retired 1/12/2001. Presently work on
contract with Health Dept, and Maxim Health services as Flu Immunization nurse.
Volunteer Experience:
Meals on Wheels ; VA Medial Center - Durham; PTA Thrift shop; Habitat for Humanity;
Fund raising for Exchange Club Child Abuse Prevention Foundation in Durham
Education:
H.S. Diploma; BS, Nursing; Adult Health Assessment certificate-UNC.
Other Comments:
Renewed application 10/09/03 for ACHCAC and Adv. Bd, on Aging, 6/16/03 for
ACHCAC; NHCAC; Adv. Bd. on Aging. Originally applied 9/3/99. Address Verification:
917 Crestwood Lane, Chapel Hill, NC 27514 is not in Chapel Hill City Limits; is in Chapel
Hill Township. and ETJ. CHPlanning Dept, nc.g/Clerk's office.
This application was current on: 10/3/2003 Date Printed: 1/15/2004
12,
Page 1 of 1
Johanna Jensen
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Sex:
Ethnic Background:
Date of Birth:
Ms Johanna Jensen
2201 Baycourt Trail
Hillsborough NC 27278
225-1925
245-1637
jjensenj@mindspring.com
Medical Technologist
Hillsborough
Female
Caucasian
9/19/1963
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Duke University Hospital, Medical Technologist, 5/1990- present
Volunteer Experience:
Education:
BS in Medical Technology, Medical College of Virginia
Other Comments:
STAFF NOTES: 10/03 Original appl. For CFW; ACHCAC. ADDRESS VERIFICATION:
2201 Baycourt Trail, Hillsborough is in Beckett's Ridge Subd, in Hillsborough City Limits,
In Hillsborough Township. MOAD/ncg .
This application was current on: 11/9/2003 Date Printed: 1/15/2004
13
Page 1 of 1
Judith Mitchell
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Ms. Judith Mitchell
3620 Dairyland Road
Hillsborough NC 27278
(919)933-8381
919-933-1851
919-933-6623
jmitche1158@earthlink.net
Retired
Township of Residence: Bingham
Zone of Residence:
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 6/20/1940
Boards/Commissions applied for:
Adult Care Home Community Advisory Committee
Work Experience:
Currently (11/03) 1 am working for Home Health Solution. Was retired from as
receptionist for Carrboro Peds. And Internal Medicine. Prior to that I worked as UNC
Student Health as a receptionist in Women's Health.
Volunteer Experience:
Department of Social Service; Orange County Fire Department - EMT - First Responder.
Education:
High School; Few courses at Community College, 18 credit hours; Adult Education
Courses.
Other Comments:
STAFF NOTES: Renewed app. 11/15/03 for A.C.H.CAC. Applied 1/16/2001 for Adult
Care Home Community Advisory Committee. OTHER COMMENTS: Very interested
in helping the adult mentally alert but physcially challenged live on their own. There is
nothing for them in this county. I also beleive that Senior Citizens should have better care
both physically and mentally. There are a lot of lonely seniors in just this county alone.
You may check with Chris Nutter or Heather Barrow for references. Or with any of the
Doctors at Carrboro Peds. And Internal Medicine.
This application was current on: 11/15/2003 Date Printed: 1/15/2004
Page 1 of 1
Shanon Pounds
Volunteer Application
Orange County Advisory Boards and Commissions
Name:
Name Called:
Home Address:
Phone: (Day)
Phone: (Evening)
Fax:
Email:
Place of Employment:
Job Title:
Township of Residence:
Zone of Residence:
Ms. Shanon Pounds
200 South Bellvue Street
Hillsborough NC 27278
919-732-2133
919-732-2133
MrsPoLindS@aol.com
Alamance Community College
Nursing Student and Care home
Hillsborough
Hillsborough Town Limits
Sex: Female
Ethnic Background: Caucasian
Date of Birth: 5/17/1973
Boards/Commissions applied for:
Animal Shelter Operations Task Force
Commission for Women
Adult Care Home Community Advisory Committee
Work Experience:
Nursing student (RN) and Family owned care home for 30 years.
Volunteer Experience:
Forsyth County Red Cross, Orange County Schools
Education:
Currently enrolled in nursing school in Alamance County.
Other Comments:
True animal lover whom adopted from the Orange County Shelter. STAFF NOTES:
Orignal application received for Animal Shelter Operations Task Force, Commission
For Women, and Adult Care Home Community Advisory Committee. ADDRESS
VERIFICATION: MOAD. 200 S. Bellevue Street, Hillsborough is within Hillsborough City
Limits. Ncg
This application was current on: 12/3/2003 12:14:15 PM Date Printed: 1/15/2004